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PTU-222 Management of radiation induced proctopathy- an objective assessment of treatment outcome-series review
  1. AM Almoudaris,
  2. WP Allingham,
  3. DJ Kearns,
  4. NJH Sturt
  1. Department of Coloproctology, Southend University Hospital NHS Foundation Trust, Southend, UK

Abstract

Introduction Management of radiation prctopothy remains challenging. We aim to objectively assess the outcome of a protocolised treatment pathway in radiation induced proctopathy

Method A prospectively maintained database of patients that were referred to our service identified patients referred following prostate cancer treatment. Through a combination of record review, telephone and in-person consultations, assessment of outcome were ascertained. The Radiation Proctitis Symptom Score (RPSS) and Late Radiation Morbidity Scores (LRMS) as well as documentation of anaemia, hospitalisations and blood transfusion requirements were analysed.

A standardised treatment protocol is implemented in our unit using a step-wise treatment including laxatives, Normacol, Sucralfate, Formalin and Hyperbaric Oxygen therapies.

Results 29 consecutive patients treated for prostate cancer were included. 2/29 (7%) had brachytherapy, 24/29 (83%) had radical and 3/24 (10%) combination radiotherapy.

Pre-treatment LRMS demonstrated 2/29 (7%) patients in grade 1, 18/29 (62%) in grade 2 and 9/29 (31%) patients in grade 3 (grade 1 = minor discharge, grade 3 = bleeding requiring hospitalisation). Pre-treatment RPSS was 4 (range 1–11) and post treatment was 1 (range 0–5) p = 0.014.

Greatest improvements were demonstrated in the rectal bleeding (68 vs. 13) and general wellbeing (9 vs. 0) sub-sections of the RPSS, p = 0.017 and p = 0.024 respectively (where lower scores represent fewer/lack of symptoms) when considering total scores for the whole cohort pre and post treatment.

Conclusion A standardised treatment protocol can objectively improve patient outcome following radiation induced proctopathy.

Disclosure of interest None Declared.

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